HomeMy WebLinkAbout410 Statement of Organization Recipient Committee - Amendment stamped - 01.05.2017 - McCoy, RobertStatemeii it of Organization
Recipier'llt Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
0 Amendment
List I.D. number:
0 1369332
07 /32014
Date qualified as committee Date qualified as committee
(If applicable)
1. Committee riformaticln„�µ,
NAME OF COMMITTEE
Robert McCoy for Council 2018
❑ Termination —See Part 5
List I.D. number:
Date of Termination
STREET ADCRESS(NO P.O. BOX) •� "'
CITY STATE IIPCODE API?A (ODE/PHONE
Cupertino CA 95014 (408)'916-7558
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FAX/ E-MAI_ ADDRESS •� — ""`�
LUUN I Y UI- UUMICILE I JURISDICTION WHERE COMMITTEE IS ACTIVE
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2, Treasurer and Other
NAME OF TREASURER
JAN2"2017 Lu
C PERTINO CITY CL FRK
Blossom NIJi
STREET ADDRESS (NO P.O. BOX) •�
CITY STATE ZIPCODE AREA -ODE/PHONE
CA (
NAME OF ASSISTANT TREASURER, IF ANY • '•'�
STREET ADDRESS (NO RO. BOX) •� •"—
CITY STATE ZIP CODE AREA ::ODE/PHONE
NAME OF PRINCIPAL OFFICER(S) •r ..�'�
STREET ADDRESS (NO P.O. BOX)
Attach additional information on appropriately.labeled continuation sheets. CITY
STATE ZIP CODE AREA CODE/PHONE
I have used
g this
ent and to the
penalty of perj ry under thpellaws of the rS aterof Californ anthat the foregoing is true aet of my kd orrecgt the information containE d herein is true anra complete. I certii' /under
Executed on 12/30/2016 _
By
DATE SIATURF
on 12/30/2016 By
DATE •_ --•— _ _
SIGNATURE OF CONTR NG OFFICEHOLDER,CANDIDATE,CiR STATE MEASURE PROPONENT •�
Executed on
DATE
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
—• SIGNATURE OF CONTROLLING• OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT •�
FPPC Form 410 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
%'vVw.fppc.ca.gov
Statement of Organiz;,Rion
Recipierrit Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Robert McCoy for Council 2018
• All committees must list the financial institution where the campaign bank account is located.
I-- — 1-1—ALIN5111UTION
AUDItSS
AREA CODE/PHONE
(
CITY
BANK ACCOUNT HUMBER
STATE ZIPCODE
CA 915014
4. Type of: Committee : Corrlplete the appllcalalesections.
Iala
. •. ill
Pere 2
I.C%NUMBER
11369332
• List the name of each controlling officeholder candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and
district number, if any, and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan."
• If this committee acts jointly with another controlled committee, li: t the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OFFICE FIOLDER/STATE MEASURE PROPONENT ELEC-I'IVE OFFICE SOUGHT OR HELD
. _ (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
i
Robert NdcCoy City Council 2018 ❑ Nonpartisan_
❑ Nonpartisan
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTE: R) CANDIDATE(S) OFFICE: SOUGHT OR HELD OR MI:ASURE(S) JURISDICTION
•„_ (INCLUDE DISTRACT NO., CITY OR COUNTY, AS APPLICABLE) HECK ONE
•�I SUPPORT OPPOSE
FPPC Form 410 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov 1;866/275-3772)
w1udw.fppc.ca.gov